NPI | 1093058224 |
---|---|
Former Name | AMANDA M. WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000551) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007019243) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2013017084) | |
Enumeration Date | 2013-04-06 |
Last Update Date | 2016-09-09 |