| NPI | 1265048946 |
|---|---|
| Former Name | ALEXA WASICEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.009148) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 112596) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2024-01-09 |