| NPI | 1538581491 |
|---|---|
| Former Name | HEATHER ROUSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60777348) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00735) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2021-04-27 |