| NPI | 1265929442 |
|---|---|
| Former Name | LYDIA WILKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95013060) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 834177) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2019-10-22 |