| NPI | 1639228679 |
|---|---|
| Former Name | DONNA MARIE CREOLA BEATY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-01213) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 2564) |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2016-05-17 |