Newly enumerated
The official enumeration date falls within the documented new-enumeration window.
- Enumeration date is 14 days before observation
Type 1 individualNPI 1215856786
DANIELLE WILSON
172V00000X · MEDINA, OH
Why this profile is appearing now
Observed change signals
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 172V00000X | 172V00000X | Primary |
| 171M00000X | 171M00000X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s