NPI | 1073177077 |
---|---|
Former Name | ELLEN C UPTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008955) |
Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0110008955) |
Enumeration Date | 2019-04-24 |
Last Update Date | 2023-08-10 |