| NPI | 1205994530 |
|---|---|
| Former Name | AMBER MARIE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 003419) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH 5845) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2022-10-31 |