| NPI | 1558951236 |
|---|---|
| Former Name | TAYLOR LEIGH WISNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95015302) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015302) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-05-19 |