| NPI | 1477064665 |
|---|---|
| Former Name | JILL MARIE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 9838) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AZ 17-1652) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2023-10-12 |