| NPI | 1750555363 |
|---|---|
| Former Name | NICHOLE J RADTKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 152367) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WI 3606-033) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2010-01-25 |