| NPI | 1710469440 |
|---|---|
| Former Name | JILLIAN ROSE PICINICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006786) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022353) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2024-02-26 |