| NPI | 1689864761 |
|---|---|
| Former Name | ANGELA RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 60727-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-109214) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2025-09-23 |