NPI | 1427385368 |
---|---|
Former Name | BETHANY LEIGH CROSBY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200313) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07362) |
Enumeration Date | 2009-11-13 |
Last Update Date | 2016-01-26 |