NPI | 1790228575 |
---|---|
Former Name | JILLIAN R RANKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 4734) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058775) |
Enumeration Date | 2016-11-28 |
Last Update Date | 2024-01-29 |