NPI | 1619426822 |
---|---|
Former Name | ANGELA K. DUGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000720) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.376211) |
Enumeration Date | 2016-09-28 |
Last Update Date | 2021-01-25 |