NPI | 1780672840 |
---|---|
Former Name | ANGELA ANDERSON MCMAHON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN117269) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN117269) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2023-12-01 |