NPI | 1134484512 |
---|---|
Former Name | JENNIFER ANN SILVIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005192) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006397) |
363AS0400X Physician Assistant, Surgical (Licence: IL 085005192) | |
Enumeration Date | 2012-07-11 |
Last Update Date | 2020-03-23 |