Individual
JILL K. PEYSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101269063
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35.146110
OHIO ELICENSE
OH
Enumeration date
04/23/2014
Last updated
10/13/2022
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