| NPI | 1275002305 |
|---|---|
| Former Name | LEAH DIANNE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OK 107046) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2022-05-03 |