Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NV |
NPI | 1134510761 |
---|---|
Provider Name | Dr. Seitheach Wilson |
First Address | Las Vegas, NV 89123-6508 |
Second Address | Las Vegas, NV 89123-6508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2015 |
Last Update Date | 28/08/2020 |