| NPI | 1548548506 |
|---|---|
| Former Name | SHALA DEANNE DICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 88765) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 723566) |
| 163W00000X Registered Nurse (Licence: CA 751989) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2018-06-05 |