| NPI | 1154075034 |
|---|---|
| Former Name | ELLE ALEXANDRA EGGLESTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008590) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CO PA.0008590) |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2024-08-21 |