| NPI | 1659650372 |
|---|---|
| Former Name | PHAEDRA D WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN168566) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169561) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2022-05-31 |