| NPI | 1275529505 |
|---|---|
| Former Name | GINA M PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IA 01060) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 5658) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-07-08 |