NPI | 1568949006 |
---|---|
Former Name | MCKENNA JENKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 2000032144) |
Enumeration Date | 2018-07-27 |
Last Update Date | 2018-07-27 |