| NPI | 1548297625 |
|---|---|
| Former Name | ANGELA L BUNDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT 221) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT Med-PAC-LIC-221) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-12-20 |