| NPI | 1144348954 |
|---|---|
| Former Name | PAULA WIESEHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 2013042951) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 123435) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-03-30 |