NPI | 1164794418 |
---|---|
Former Name | ERIKA ALYSE WAGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0060136) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 1063) |
Enumeration Date | 2012-02-02 |
Last Update Date | 2022-06-22 |