| NPI | 1013568724 |
|---|---|
| Former Name | AMBER DAWN PETTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: IN 71009345A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 71009345A) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2022-05-31 |