| NPI | 1609287580 |
|---|---|
| Former Name | ELLEN M WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.155448) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD465034) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2026-03-30 |