| NPI | 1912131194 |
|---|---|
| Former Name | JENNIFER ELAINE BUSHMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2013-01388) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2013-07-17 |