| NPI | 1912212655 |
|---|---|
| Former Name | CORTNEY CELESTE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NC 2012-01297) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2012-01297) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2022-03-31 |