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 |