| NPI | 1700270683 |
|---|---|
| Former Name | JESSICA ERIN HEIDENBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 308905) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PA MT219716) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2022-10-12 |