| NPI | 1558645812 |
|---|---|
| Former Name | JENNA MCCLAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA165997) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003673) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2021-09-15 |