NPI | 1306130786 |
---|---|
Former Name | IRISSA N. WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME120306) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME120306) |
Enumeration Date | 2011-06-03 |
Last Update Date | 2023-01-12 |