NPI | 1003970476 |
---|---|
Former Name | CHRISTEN LEIGH KAVANAUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 855767) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CA 215503) |
Enumeration Date | 2006-12-20 |
Last Update Date | 2016-08-02 |