NPI | 1538114764 |
---|---|
Professional Name | SUSAN MARIE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 123BB9961) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2007-07-08 |