| NPI | 1427048719 |
|---|---|
| Former Name | ELLEN WINGARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.120283) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 229137) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2015-01-12 |