NPI | 1568007326 |
---|---|
Former Name | ANGELA RITENOUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114052) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA005045) |
Enumeration Date | 2019-11-15 |
Last Update Date | 2021-08-11 |