Emile Willard Ellender Legendre, PA Valid NPI

Individual provider · Physician Assistant · Lafayette, LA

NPI

1962984005

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

310500 (LA)

Sex

Male

Sole proprietor

No

Enumerated

2018-09-05

Last updated

2018-11-30