| NPI | 1124105457 |
|---|---|
| Former Name | ELLISA RAUSCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2699) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 45018) |
| 207Q00000X Family Medicine (Licence: SC LL28867) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-06-06 |