| NPI | 1154372076 |
|---|---|
| Other Name | ANGELA LYN WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 1224) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000001224) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-07-01 |