| NPI | 1639155740 |
|---|---|
| Other Name | STACEY ANGULO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 53563) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 2272) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2018-03-17 |