| NPI | 1316358609 |
|---|---|
| Other Name | KAYLA JEAN WIESNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 293419) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2019-07-03 |