| NPI | 1457995201 |
|---|---|
| Former Name | NICOLE LEE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2023-12-11 |