| NPI | 1386683217 |
|---|---|
| Former Name | ANGELA L GUNDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004064) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004064) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-11-27 |