| NPI | 1598028524 |
|---|---|
| Former Name | ANGELA SUZANNE RICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 43431) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A138852) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2023-01-12 |