| NPI | 1164783858 |
|---|---|
| Former Name | ALEXANDRA WIGGINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME122141) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN17556) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2015-08-26 |