| NPI | 1518313089 |
|---|---|
| Professional Name | MARK ALLEN WILSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |