| NPI | 1003214362 |
|---|---|
| Former Name | CAROLINE BROOKE WISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL PA9108197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA PA9108197) |
| 363A00000X Physician Assistant (Licence: FL PA9108197) | |
| 363AM0700X Physician Assistant, Medical (Licence: GA P007584) | |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2020-04-06 |