NPI | 1306496294 |
---|---|
Former Name | ANGELICA CHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54712) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061029) |
Enumeration Date | 2019-09-12 |
Last Update Date | 2023-09-14 |