Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 575 | AK |
NPI | 1699042861 |
---|---|
Provider Name | Dr. Maria C Angel |
First Address | Wasilla, AK 99687-6424 |
Second Address | Wasilla, AK 99654-8449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2011 |
Last Update Date | 12/04/2018 |