NPI | 1417915950 |
---|---|
Former Name | ANGELA L PETERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY 550) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10062) |
Enumeration Date | 2006-05-03 |
Last Update Date | 2021-05-24 |