NPI | 1083885206 |
---|---|
Former Name | JANA NICOLE POLSLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003713) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-003188) |
Enumeration Date | 2008-03-15 |
Last Update Date | 2013-02-18 |