| NPI | 1659853356 |
|---|---|
| Former Name | JILL ELAINE SANFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12144) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA12144) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2021-11-09 |