| NPI | 1194257758 |
|---|---|
| Former Name | ANGELA L BAZEMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography (Licence: MD 108395) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2025-04-15 |