| NPI | 1376042507 |
|---|---|
| Former Name | BETHANY A BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11769) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11769) |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2025-06-11 |