| NPI | 1013458868 |
|---|---|
| Former Name | ANGELIQUE MAHAVONGTRAKUL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A182001) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2024-03-21 |