| NPI | 1942646872 |
|---|---|
| Former Name | JILLIAN BIDWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006638) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601006638) |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2020-05-08 |