| NPI | 1902432685 |
|---|---|
| Former Name | THERESE VALLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4955-23) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WI 4955-23) |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2020-03-13 |