| NPI | 1093250920 |
|---|---|
| Former Name | JACQUELINE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019391) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2017-10-31 |