NPI | 1376045187 |
---|---|
Former Name | MOLLY ELIZABETH BUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012185) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 022368) |
Enumeration Date | 2018-03-07 |
Last Update Date | 2019-05-01 |