| NPI | 1265837132 |
|---|---|
| Former Name | BRITTANY M WIENKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 804000131) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 861415141) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2019-04-25 |