NPI | 1316246531 |
---|---|
Former Name | DAISY GRACIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX P9716) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A141908) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-03-28 |
Last Update Date | 2018-10-05 |