NPI | 1164172722 |
---|---|
Former Name | ASHLEIGH NICOLE PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 34326) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-03-26 |
Last Update Date | 2025-06-09 |