NPI | 1134492135 |
---|---|
Former Name | JENNIFER BURNS GONNELLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: VA 0121000792) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP3079) |
Enumeration Date | 2012-02-22 |
Last Update Date | 2016-08-26 |