Individual
FELICIA OTOO
Active
Individual
FELICIA OTOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002174
CT
363AM0700X
Medical Physician Assistant
Primary
002174
CT
363AS0400X
Surgical Physician Assistant
2174
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003021748
—
CT
Enumeration date
11/05/2008
Last updated
03/05/2014
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