| NPI | 1912247081 |
|---|---|
| Former Name | JASMINE NICOLE CHURCHILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007227) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030922) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2022-10-11 |