| NPI | 1679612980 |
|---|---|
| Former Name | SHILA RENAE TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 680322) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 111635) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |