NPI | 1609266618 |
---|---|
Former Name | TABITHA RUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-110086) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-110086) |
Enumeration Date | 2015-01-28 |
Last Update Date | 2024-01-31 |