NPI | 1609802461 |
---|---|
Former Name | JENNIFER ANN BRILLHART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA002018L) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002018L) |
363AM0700X Physician Assistant, Medical (Licence: PA MA002018L) | |
Enumeration Date | 2006-06-24 |
Last Update Date | 2021-05-19 |