| NPI | 1295338978 |
|---|---|
| Former Name | CARRIE LIN WISDOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1074272) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79817-091) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2024-02-14 |