| NPI | 1366648834 |
|---|---|
| Former Name | JAMIE L WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00046932) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N1345) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-02-25 |