| NPI | 1902207228 |
|---|---|
| Former Name | ISHA JUANELLE WILTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07953) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2019-07-03 |