| NPI | 1063587012 |
|---|---|
| Former Name | NANCY ELIZABETH WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: HI 12368) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD00031728) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2012-02-01 |