| NPI | 1063585727 |
|---|---|
| Former Name | AMANDA L WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: 348484) |
| Additional Taxonomies | 2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: 348484) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |