| NPI | 1629176946 |
|---|---|
| Former Name | MARY SUSAN BUNTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030732) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C04613) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-12-30 |