NPI | 1548632623 |
---|---|
Former Name | EMILY RUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X (Licence: AZ AP8250) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ TAP8250) |
208VP0000X (Licence: UT 13880105-4405) | |
Enumeration Date | 2015-10-28 |
Last Update Date | 2025-09-30 |