| NPI | 1366475204 |
|---|---|
| Former Name | PEGGY SUE RICKETTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003216) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2025-07-11 |