| NPI | 1891196630 |
|---|---|
| Former Name | EMILY R DETTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057130) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003381) |
| 363A00000X Physician Assistant (Licence: PA MA057130) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2024-09-18 |