Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | P3099 | TX |
NPI | 1326366147 |
---|---|
Provider Name | Dr. Alison Wiesenthal |
First Address | Fort Sam Houston, TX 78234-4504 |
Second Address | San Antonio, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2010 |
Last Update Date | 29/04/2020 |