| NPI | 1437985959 |
|---|---|
| Former Name | MALLORY JOY WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0037966) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH RN.441765) |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-11-18 |