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 |