| NPI | 1164468443 |
|---|---|
| Former Name | MARINA S WILDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 0-42000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 042000) |
| 163WW0000X Registered Nurse, Wound Care (Licence: GA 042000) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-08-12 |