| NPI | 1891180154 |
|---|---|
| Former Name | DARA ANN WISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036148462) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA DO-05341) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2022-04-19 |