| NPI | 1245483486 |
|---|---|
| Former Name | ANGELA C. TISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 005464) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005464) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2014-01-31 |