| NPI | 1134871775 | 
|---|---|
| Professional Name | AMANDA WILSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163WL0100X Registered Nurse, Lactation Consultant (Licence: TX 780850)  | 
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: VA L-305357)  | 
| Enumeration Date | 2022-01-25 | 
| Last Update Date | 2022-01-25 |