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 |