| NPI | 1134500010 |
|---|---|
| Former Name | HALEY JOY WAREHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3722) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52581) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2020-09-23 |