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 |