NPI | 1578058988 |
---|---|
Former Name | BETHANY AMARIS MAGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06855) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062413) |
Enumeration Date | 2018-06-27 |
Last Update Date | 2021-05-07 |