| NPI | 1174191050 |
|---|---|
| Former Name | ANGELINA MARIE OMODT-LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 76978) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT223112) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-08-06 |