| NPI | 1548227879 |
|---|---|
| Former Name | JILL M WIECH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010802) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052482) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2010-09-23 |