NPI | 1801842414 |
---|---|
Former Name | TRACI BUXTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4043) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-2906) |
207Q00000X Family Medicine (Licence: SC 52321) | |
207Q00000X Family Medicine (Licence: MD 84937) | |
207Q00000X Family Medicine (Licence: MO 2014008185) | |
207Q00000X Family Medicine (Licence: FL ME137487) | |
Enumeration Date | 2006-05-25 |
Last Update Date | 2019-08-19 |