NPI | 1386041424 |
---|---|
Former Name | BONITA HACHEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60805768) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51766) |
Enumeration Date | 2014-12-03 |
Last Update Date | 2020-11-30 |