| NPI | 1811106222 |
|---|---|
| Former Name | ELLEN GUNDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP 9373273) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 300456) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-04-14 |