NPI | 1346313483 |
---|---|
Former Name | LYNN M HEISEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 1056) |
Enumeration Date | 2006-11-16 |
Last Update Date | 2022-11-07 |