| NPI | 1235363276 |
|---|---|
| Former Name | CANDACE I. WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 142329) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 142329) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2021-11-08 |