| NPI | 1750628046 |
|---|---|
| Former Name | JENNIFER LYNNE MENDIOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V3929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08394) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2024-09-16 |