NPI | 1093934713 |
---|---|
Former Name | JENNIFER BUNDALIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A-105453) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08216000) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2022-02-11 |