| NPI | 1356503452 |
|---|---|
| Former Name | BETHANY LYNNE PURNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015232-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00195600) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-05-11 |