Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 700 | NE |
NPI | 1033366927 |
---|---|
Provider Name | Kristen Bunch |
First Address | Dupont, WA 98327-8739 |
Second Address | Tripler Army Medical Center, HI 96859-5001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2008 |
Last Update Date | 27/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
700 | (05) | NE |