| NPI | 1770991838 |
|---|---|
| Former Name | JENNIFER ERIN MAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WV 10445) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2022-04-06 |