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 |