| NPI | 1295196384 |
|---|---|
| Other Name | JACOB EDWARD PETERSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 76208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101263068) |
| 208D00000X General Practice (Licence: VA 0101263068) | |
| 208M00000X Hospitalist (Licence: VA 0101263068) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2024-10-17 |