NPI | 1215283775 |
---|---|
Professional Name | SHENELLE NICOLE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: GA 85818) |
Additional Taxonomies | 208800000X Urology (Licence: AL 36843) |
Enumeration Date | 2012-08-01 |
Last Update Date | 2023-09-13 |