NPI | 1265653745 |
---|---|
Former Name | BRITTANY ANNE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: WY 7978A) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A104743) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2014-08-04 |