| NPI | 1487611919 |
|---|---|
| Former Name | LORI JESSICA WYLIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 23535) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2008-04-24 |