NPI | 1285735654 |
---|---|
Other Name | THERESA TRAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C6465) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AR C-6465) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2016-07-15 |