Individual
ANGELA S LATHAM
Active
Individual
ANGELA S LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004297
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084105015A
—
GA
Enumeration date
07/30/2006
Last updated
02/11/2011
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