| NPI | 1508823212 |
|---|---|
| Former Name | THERESA ANN HANES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 021883) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-08-04 |