| NPI | 1639782907 |
|---|---|
| Former Name | JENNA OTTMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36003333A) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: IN 36003333A) |
| 2083S0010X Preventive Medicine, Sports Medicine (Licence: IN 36003333A) | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2021-01-06 |