NPI | 1255614145 |
---|---|
Former Name | ANGELA CHASE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME 1269PA) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1269) |
Enumeration Date | 2011-09-27 |
Last Update Date | 2020-02-04 |