| NPI | 1679117717 |
|---|---|
| Former Name | ALLISON RAE EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 3107) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2021-09-13 |