| NPI | 1427413285 |
|---|---|
| Former Name | NICKY S PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA NMW235760) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 95003494) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2020-05-08 |