| 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 |