Individual
MONIQUE JUSTINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15055 LOS GATOS BLVD STE 100, LOS GATOS, CA 95032-2056
(408) 356-1000
(408) 356-1125
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A143347
CA
Other
Enumeration date
07/11/2008
Last updated
07/08/2022
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