| NPI | 1003251604 |
|---|---|
| Former Name | JENNIFER CAMILLE BUENZLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 54329) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2016-12-15 |