NPI | 1508571977 |
---|---|
Former Name | RACHEL PETERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007724) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007724) |
Enumeration Date | 2023-01-19 |
Last Update Date | 2024-03-21 |