| NPI | 1013567395 |
|---|---|
| Former Name | ANGELA TATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 104954) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WV 81458) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2023-04-12 |