| NPI | 1194276568 |
|---|---|
| Former Name | BRITTANY WADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: WI 68218) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2023-08-10 |