NPI | 1073046330 |
---|---|
Former Name | AMANDA WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0061848) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0061848) |
Enumeration Date | 2017-04-04 |
Last Update Date | 2021-06-14 |