| NPI | 1871121269 |
|---|---|
| Former Name | BETHANY ERIN SHAFFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10527) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NC 0010-10527) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-03-04 |