| NPI | 1366437527 |
|---|---|
| Former Name | ANGELA M BACKUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 309) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 970) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2023-10-09 |