NPI | 1417235904 |
---|---|
Former Name | KARIE SUE PEPE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004577) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2139) |
363A00000X Physician Assistant (Licence: AK 985) | |
Enumeration Date | 2011-08-01 |
Last Update Date | 2023-04-25 |