NPI | 1457966376 |
---|---|
Former Name | ANGELA M SHEARON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003079A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID 3771758) |
Enumeration Date | 2020-09-09 |
Last Update Date | 2025-05-21 |