NPI | 1194287359 |
---|---|
Former Name | JILL ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125075283) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2601) |
Enumeration Date | 2019-04-04 |
Last Update Date | 2022-10-12 |