| NPI | 1881939288 |
|---|---|
| Former Name | ANGELA TULLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA160417) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2020-12-29 |