NPI | 1518526565 |
---|---|
Former Name | EMILY KATHERINE DEPUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3242) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-06-12 |
Last Update Date | 2023-01-27 |