NPI | 1720344997 |
---|---|
Former Name | DIANA CAROLYN GOMEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q5379) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-02 |
Last Update Date | 2023-02-01 |