NPI | 1881663557 |
---|---|
Former Name | ALEXIS ANN WIESENTHAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N1219) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 36165) |
207R00000X Internal Medicine (Licence: CA A103118) | |
Enumeration Date | 2006-03-15 |
Last Update Date | 2025-02-28 |