| NPI | 1316455850 |
|---|---|
| Former Name | NICOLE E WAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02608) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2834) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2022-12-12 |