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 |