| NPI | 1356680292 |
|---|---|
| Former Name | CAROLYN W BEAUCHAMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08335) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2022-11-04 |