| NPI | 1760844419 |
|---|---|
| Former Name | JENNIFER MARIE WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX R5676) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R5676) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2020-07-22 |