NPI | 1679063184 |
---|---|
Former Name | CALLIE ANN BAUSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S4179) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10063983) |
Enumeration Date | 2018-05-10 |
Last Update Date | 2021-09-27 |