| NPI | 1619084324 |
|---|---|
| Former Name | MARY ANN ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00031537) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD18609) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |