Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 125-064315 | IL |
NPI | 1003259052 |
---|---|
Provider Name | Dr. Jillian Kent |
First Address | Buffalo, NY 14215-1946 |
Second Address | Buffalo, NY 14214-2648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 19/09/2019 |