| NPI | 1700099215 |
|---|---|
| Other Name | JERRY ROBERT WENIGER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110002843) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126000634) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-08-05 |