| NPI | 1487843322 |
|---|---|
| Former Name | BETHANY L TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1573) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-852) |
| 363AM0700X Physician Assistant, Medical (Licence: OR PA01283) | |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2018-01-24 |