| NPI | 1154779932 |
|---|---|
| Former Name | ANGELA M LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 289071) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03732) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 289071) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-12-13 |