| NPI | 1205053865 |
|---|---|
| Former Name | WENDY DREW WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TN MD47125) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0061234) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 47125) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0061234) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2024-08-22 |