NPI | 1891726980 |
---|---|
Former Name | CHERYL LYN HEINTZELMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001866) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2006-07-06 |
Last Update Date | 2024-10-17 |