| 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 (Licence: AR C-6465) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-07-15 |