| NPI | 1083811194 |
|---|---|
| Former Name | IVY BUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 123169) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND9738) |
| 163WD0400X Registered Nurse, Diabetes Educator (Licence: KY 294093) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2024-10-11 |