NPI | 1487837001 |
---|---|
Other Name | ELLEN MAUREEN FONVILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WI 521) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1692077) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN LAT104292845) | |
Enumeration Date | 2007-12-06 |
Last Update Date | 2011-08-15 |