| NPI | 1992993794 |
|---|---|
| Former Name | ELLEN CHENEY ROBERTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD19939) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD.202518) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2015-08-25 |