| NPI | 1619313640 |
|---|---|
| Former Name | JILLIAN ALEXIS WEISSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60713585) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN18623) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2023-03-22 |