| NPI | 1831719673 |
|---|---|
| Former Name | ANGELA SHUPE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CO ANT.0000217) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MO Applied) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2024-04-02 |