| NPI | 1619517414 |
|---|---|
| Former Name | BETHANY LOUISE ZABLOTSKY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61563479) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 5934) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 6139) | |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2024-09-16 |