| NPI | 1750383618 |
|---|---|
| Former Name | MELITA JOYCE PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L4176) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.200657) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-08-18 |