| NPI | 1164756102 |
|---|---|
| Former Name | HEATHER NICOLE HALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 3065) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 20240000084) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2024-01-09 |