| NPI | 1144289265 |
|---|---|
| Former Name | ANGELA DIANE SPROLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12458139-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA03137) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60302788) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2021-12-20 |