| NPI | 1053842047 |
|---|---|
| Former Name | LISA ANNETTE PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2017007335) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5377595) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2018-02-09 |