| NPI | 1972096220 |
|---|---|
| Former Name | WINNIE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 112458) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.031606) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2026-04-18 |