| NPI | 1700331527 |
|---|---|
| Other Name | THEODORE JAMES HEGNER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 5569) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.005902) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2023-05-23 |