| NPI | 1598256497 |
|---|---|
| Former Name | CANDICE MIRANDA GRANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T4868) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-12586) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 680132) | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2024-10-08 |