NPI | 1083804991 |
---|---|
Former Name | ELLEN STEWART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1250) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2312) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2025-02-21 |