NPI | 1104140821 |
---|---|
Former Name | LINDSAY WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03942) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003707) |
Enumeration Date | 2010-03-24 |
Last Update Date | 2021-03-09 |