| NPI | 1740287861 |
|---|---|
| Former Name | CHRISTINE HENINGER-BROKEN LEG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 260807-1206) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2007-07-16 |