| NPI | 1336550557 |
|---|---|
| Former Name | JILL E PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: IL 041219070) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |