| NPI | 1215550827 |
|---|---|
| Former Name | JENNIFER MICHELE MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 002667) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-05-19 |