Individual
DARYL ANDERS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
150 BROAD ST, HAMILTON, NY 13346-9575
(315) 824-6070
Mailing address
150 BROAD ST, HAMILTON, NY 13346-9575
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308946-1
NY
Other
Enumeration date
11/10/2018
Last updated
11/10/2018
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