| NPI | 1891417283 |
|---|---|
| Former Name | ALYSSA WICHMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.025451) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022034477) |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2024-04-26 |