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Individual
WILSON THOMAS
Active
Individual
WILSON THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
690140
NY
363LF0000X
Family Nurse Practitioner
Primary
342773
NY
Other
Enumeration date
03/06/2018
Last updated
11/01/2018
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