NPI | 1124312764 |
---|---|
Former Name | JULIA ANNE DONELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P5969) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP1-0040987) |
Enumeration Date | 2011-05-31 |
Last Update Date | 2014-08-06 |