| NPI | 1912985516 |
|---|---|
| Former Name | CHARLOTTE ROSE WISMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: KY 2905P) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2008-08-25 |