NPI | 1598256497 |
---|---|
Former Name | CANDICE MIRANDA GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-12586) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 680132) |
Enumeration Date | 2018-05-25 |
Last Update Date | 2021-05-19 |