NPI | 1245597335 |
---|---|
Former Name | VICTORIA LUEVANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1368) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX Q1368) |
Enumeration Date | 2012-04-13 |
Last Update Date | 2023-04-14 |