| NPI | 1205867892 |
|---|---|
| Professional Name | ALESIA J WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A8597) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS0017549) |
| 207Q00000X Family Medicine (Licence: MO R3E50) | |
| 207Q00000X Family Medicine (Licence: NV 5121) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-11-19 |