| NPI | 1639167638 |
|---|---|
| Other Name | ELLEN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00024413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 14042) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2021-04-14 |