NPI | 1952769614 |
---|---|
Former Name | KATRENA L WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AR A004655) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A004655) |
Enumeration Date | 2016-02-09 |
Last Update Date | 2022-06-21 |