| NPI | 1336257500 |
|---|---|
| Former Name | JEFFREY T HENNEBERGER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME136228) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 13314) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 13314) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2024-03-18 |