| NPI | 1063657294 |
|---|---|
| Former Name | HEATHER HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 2255) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013037) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2022-09-26 |