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Individual
WILSON MAK
Active
Individual
WILSON MAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
812700
CA
363LF0000X
Family Nurse Practitioner
Primary
95000312
CA
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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