| NPI | 1417361031 |
|---|---|
| Former Name | MARY A BEASLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004615) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2020-02-07 |