| NPI | 1720275746 |
|---|---|
| Former Name | TERESA BUCKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA TAP1715) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN110077) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2021-09-20 |