NPI | 1265480537 |
---|---|
Former Name | SALLY J GILL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 997) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 076029) |
363AS0400X Physician Assistant, Surgical (Licence: NE 997) | |
Enumeration Date | 2006-05-05 |
Last Update Date | 2020-12-31 |