NPI | 1447765797 |
---|---|
Former Name | HEATHER ALISON BATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ND 559-14) |
Enumeration Date | 2017-12-08 |
Last Update Date | 2022-08-17 |