| NPI | 1346433422 |
|---|---|
| Former Name | ALEXIS LEIGH WAGMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101016164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS10098) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2019-06-27 |