| NPI | 1619283066 |
|---|---|
| Former Name | JAMIE WILLOUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05088) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054475) |
| 363A00000X Physician Assistant (Licence: VA 0110004031) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2015-05-29 |