| NPI | 1538503073 |
|---|---|
| Former Name | KARLYE NICOLE WISDOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 66025-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 58189) |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2024-01-25 |