| NPI | 1215982624 |
|---|---|
| Former Name | JILL NICOLE WASSERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 00773) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 000773) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-09-11 |