NPI | 1144556564 |
---|---|
Former Name | DACY R WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3015650) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 4087) |
Enumeration Date | 2009-10-20 |
Last Update Date | 2023-07-27 |