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NPI Profile for LEONARD T WONNENBERG in HURON, SD.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1609147461 |
|
| Status | Active | |
| Credentials | PAC | |
| Entity | Individual | |
| Enumeration date | 01/25/2012 | |
| Last updated | 01/08/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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LEONARD T WONNENBERG
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LEONARD T WONNENBERG, PAC