| NPI | 1356799506 |
|---|---|
| Former Name | JANE REEVES JUMONVILLE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME151479) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301502077) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2021-09-02 |