NPI | 1861777567 |
---|---|
Former Name | ANGELA COLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118352) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 08504082) |
Enumeration Date | 2011-10-14 |
Last Update Date | 2025-02-26 |