| NPI | 1396188041 |
|---|---|
| Former Name | JACQUELINE S MCCORKLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX SA00870) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 186634) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2021-12-27 |