| NPI | 1699304865 |
|---|---|
| Former Name | ALEXANDRIA BRENNA WIEDENMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 39501) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-08-30 |