NPI | 1396962080 |
---|---|
Former Name | REBECCA LYNNE BUSHWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 146M00000X Emergency Medical Technician, Intermediate (Licence: VT 95584) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040-0003298) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2007-07-08 |