NPI | 1114414091 |
---|---|
Former Name | ALEXANDRA LINN WAGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD471383) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-04-17 |
Last Update Date | 2022-10-14 |