| NPI | 1114509874 |
|---|---|
| Former Name | GINA F WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA LVN282191) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-12-09 |