| NPI | 1003619073 |
|---|---|
| Former Name | BLISS CORBITT WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL TRN44924) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2026-07-07 |