NPI | 1225525702 |
---|---|
Former Name | CHELSEA WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018729) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018729) |
Enumeration Date | 2018-04-19 |
Last Update Date | 2020-08-27 |