| NPI | 1184706806 | 
|---|---|
| Former Name | DALENA MAE WENNER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00302) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001000302) | 
| Enumeration Date | 2006-10-20 | 
| Last Update Date | 2025-06-03 |