| NPI | 1316220049 | 
|---|---|
| Former Name | RIKKI L LONG | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AR PA-452) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-452) | 
| 363AM0700X Physician Assistant, Medical (Licence: AR PA-452) | |
| Enumeration Date | 2011-09-20 | 
| Last Update Date | 2025-05-08 |