| NPI | 1912928995 |
|---|---|
| Other Name | COLEY M. VITZTUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 119022) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 74527) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-09-08 |