| NPI | 1760972491 |
|---|---|
| Former Name | JILLIAN ALEXANDRA GOODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009247) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95059691) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-06-21 |