NPI | 1346635935 |
---|---|
Former Name | ANGELA JOAN VAN ATTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60939811) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-01 |
Last Update Date | 2021-03-25 |