| NPI | 1144726670 |
|---|---|
| Other Name | MARTY J WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 1741) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 1741) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-02-05 |