| NPI | 1063975944 |
|---|---|
| Former Name | DONNA MARIE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN146542) |
| Additional Taxonomies | 163WX0003X Registered Nurse, Obstetric, Inpatient (Licence: GA RN146542) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-08-05 |