| NPI | 1730266313 |
|---|---|
| Former Name | BEVERLY WHALEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 1454) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000001454) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-03-03 |