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1740817469
DANIELLE IMANI ELLIS
BOSTON, MA
NPI
1740817469
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-24
Last Update Date
2020-03-24
Business Address
DANIELLE IMANI ELLIS MD
55 FRUIT ST
BOSTON, MA 02114-2621
Phone number: 617-726-2803
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Mailing Address
DANIELLE IMANI ELLIS MD
610 SORRELL SPRING CT
WAXHAW, NC 28173-7454
Phone number:
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