| NPI | 1669647871 |
|---|---|
| Other Name | KIMBERLY ANNE WISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-42197) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 65701) |
| 208000000X Pediatrics (Licence: NC 148910) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2020-02-11 |