| NPI | 1104216845 |
|---|---|
| Former Name | KATHLEEN J WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1119813) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: AL 1119813) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-17 |