| NPI | 1720286115 |
|---|---|
| Former Name | ANGELIQUE A JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD27938) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.27938) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2017-05-10 |