NPI | 1588630107 |
---|---|
Former Name | JILL E SMOLDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2168) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004821) |
Enumeration Date | 2006-02-23 |
Last Update Date | 2024-05-02 |