NPI | 1851581573 |
---|---|
Former Name | BETHANY R DANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 015254) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN PA1507) |
363A00000X Physician Assistant (Licence: NH 0796) | |
Enumeration Date | 2007-07-30 |
Last Update Date | 2011-10-25 |