| NPI | 1245743913 |
|---|---|
| Former Name | SONYA RENEE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09837) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A005409) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2018-11-27 |