| NPI | 1851021752 |
|---|---|
| Former Name | JENNA MARIE RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10080613) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-09-21 |