| NPI | 1154726628 |
|---|---|
| Former Name | HEATHER WAUTIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13136) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86030246) |
| 363A00000X Physician Assistant (Licence: WA PA60885717) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2020-08-24 |