NPI | 1770903429 |
---|---|
Former Name | ELLEN AMY ADAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 60094) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A152846) |
208000000X Pediatrics (Licence: MN 60094) | |
208000000X Pediatrics (Licence: CA A152846) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-21 |
Last Update Date | 2023-06-21 |