| NPI | 1265840698 |
|---|---|
| Other Name | LAURA LEE PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4956-23) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2023-06-07 |