| NPI | 1629300181 |
|---|---|
| Former Name | HEATHER BOEHM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 005997) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005997) |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2011-02-15 |