| NPI | 1992476923 |
|---|---|
| Former Name | CORRINE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 29317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021037182) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2024-12-12 |