| NPI | 1497955025 |
|---|---|
| Former Name | HEIDI LYNN FITZGERALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-099767) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 48716) |
| 208600000X Surgery (Licence: MA 235499) | |
| 208600000X Surgery (Licence: NH 14497) | |
| 208600000X Surgery (Licence: OH 099767) | |
| Enumeration Date | 2007-07-22 |
| Last Update Date | 2012-11-30 |