| NPI | 1962815357 |
|---|---|
| Former Name | JENNIFER MARY MACKIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP126196) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 102530) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2019-03-05 |