| NPI | 1356458855 |
|---|---|
| Former Name | TABITHA JO MCINTYRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO 167291) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 141566-030) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |