| NPI | 1619144243 |
|---|---|
| Former Name | ELLEN DIVERIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP 2521) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00072100) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2016-12-03 |