| NPI | 1619742160 |
|---|---|
| Former Name | ALISSA GAIL WILES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 28302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 265501) |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2024-02-22 |