NPI | 1629418181 |
---|---|
Former Name | ELLEN ROSE SOLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18166) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 8214293) |
Enumeration Date | 2013-06-28 |
Last Update Date | 2014-07-13 |