| NPI | 1861687709 |
|---|---|
| Former Name | KATHERINE B WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053232) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA TMA051810) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2016-06-10 |