| NPI | 1255863932 |
|---|---|
| Former Name | JENNA MCCRACKEN PARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA md-50097) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2022-08-30 |