| NPI | 1518395474 |
|---|---|
| Former Name | ERIN KAVANAGH WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601007868) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 016874) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2021-02-25 |