NPI | 1417041138 |
---|---|
Former Name | JACQUELINE ELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD26263) |
Additional Taxonomies | 174400000X Specialist (Licence: TN 026263) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2022-03-28 |