| NPI | 1295408987 |
|---|---|
| Former Name | HALEY BUTRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08213) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062660) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2023-04-10 |