| NPI | 1124786306 |
|---|---|
| Former Name | CHRISTINA MARIE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2020038841) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 2010020963) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-79675-071) | |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2021-12-03 |