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Individual
DR. ILAVENIL WILSON
Active
Individual
DR. ILAVENIL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A143922
CA
208600000X
Surgery Physician
A143922
CA
208D00000X
General Practice Physician
A143922
CA
Other
Enumeration date
05/13/2014
Last updated
12/06/2021
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