Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 0102202998 | VA |
N | 2080P0207X | Pediatric Hematology-Oncologist | PENDING | NY |
NPI | 1245378538 |
---|---|
Provider Name | Dr. Christina Wiedl |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23298-0510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 27/12/2012 |