| NPI | 1528456720 |
|---|---|
| Former Name | LELA WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC WILS-5M9E9H) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |