| NPI | 1366067779 |
|---|---|
| Former Name | MEGAN ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 5151014474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101027579) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151014474) | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2023-12-27 |