| NPI | 1902518657 |
|---|---|
| Former Name | ALLISON NICOLE WANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0924) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: ND PAC0924) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2024-07-22 |