| NPI | 1053521112 |
|---|---|
| Former Name | AMY LYNETTE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0006759) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-3-26988) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-12-05 |