| NPI | 1669500120 |
|---|---|
| Former Name | THERESA M. BAUTISTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APN001380) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP30007643) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: DC 1007373) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-05-31 |