| NPI | 1104354323 |
|---|---|
| Former Name | ASHLEY WIEXZOREK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WA OP61300932) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA OP61300932) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101024229) | |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2024-09-05 |