| NPI | 1023336583 |
|---|---|
| Former Name | KIMBERLY LOUISE HEBELER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 004207) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005713) |
| 363A00000X Physician Assistant (Licence: OH 50.003040) | |
| 363A00000X Physician Assistant (Licence: NJ 25MP00236100) | |
| 363A00000X Physician Assistant (Licence: CT 004207) | |
| 363AM0700X Physician Assistant, Medical (Licence: CT 004207) | |
| Enumeration Date | 2010-05-08 |
| Last Update Date | 2022-01-17 |