| NPI | 1649537853 |
|---|---|
| Former Name | PHYLICIA D DUPREE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61555498) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S7041) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2024-07-19 |