NPI | 1083991939 |
---|---|
Former Name | CHRISTINE M DEANGELO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085004167) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004167) |
Enumeration Date | 2011-11-07 |
Last Update Date | 2021-06-22 |