| NPI | 1295138931 |
|---|---|
| Former Name | BRITTA LEE PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 11629) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 3455-23) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2022-09-20 |