| NPI | 1588939151 |
|---|---|
| Former Name | ELLEN DASSABOUTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: GA RN209228) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2022-11-17 |