| NPI | 1104557206 |
|---|---|
| Other Name | JAMIE WILSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11020316) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020316) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2024-05-24 |