| NPI | 1447812102 |
|---|---|
| Former Name | DENISE J PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G155093) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |