| NPI | 1164091112 |
|---|---|
| Former Name | ERIN MARIE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5497) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1185363) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2024-08-21 |