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Individual

DR. ELIZABETH SOFIA BULLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2007-00178
NC
2084P0800X
Psychiatry Physician
M2574
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5907021
NC
Enumeration date
06/04/2007
Last updated
09/18/2013
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