NPI | 1013229178 |
---|---|
Former Name | JESSICA WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102202924) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2022025231) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0102202924) | |
Enumeration Date | 2010-07-06 |
Last Update Date | 2023-09-01 |