| NPI | 1619169968 |
|---|---|
| Former Name | MICHELE LEE WIEGMANN-ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN145899NP) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2015-07-13 |