NPI | 1811240518 |
---|---|
Former Name | ANGELA DAWN KAKALEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106417) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004576) |
Enumeration Date | 2012-10-18 |
Last Update Date | 2023-03-06 |