NPI | 1073505285 |
---|---|
Former Name | ANGELINA M CAMINO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007026) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 009607) |
363AM0700X Physician Assistant, Medical (Licence: NY 009607) | |
Enumeration Date | 2005-08-16 |
Last Update Date | 2021-02-05 |