NPI | 1801079488 |
---|---|
Former Name | DALTON J ELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 48378) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 25129) |
Enumeration Date | 2007-12-06 |
Last Update Date | 2020-02-17 |