| NPI | 1194927053 |
|---|---|
| Other Name | AMY WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C10007447) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DE C10007447) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2011-10-22 |