NPI | 1346500360 |
---|---|
Former Name | WILSA M.S. CHARLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A128767) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A128767) |
2084S0010X Psychiatry & Neurology, Sports Medicine (Licence: CA A128767) | |
Enumeration Date | 2012-05-23 |
Last Update Date | 2024-01-07 |