| NPI | 1487337259 |
|---|---|
| Former Name | BROOKE ELIZABETH WIGAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1130404) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1130404) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-11-16 |