| NPI | 1669442133 |
|---|---|
| Former Name | SHERRY GRACE BUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.10344) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.A10344) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2025-08-11 |