| NPI | 1518498062 |
|---|---|
| Former Name | HAILEY LYNN LAROCQUE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-01879) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2020-01879) | |
| 207Q00000X Family Medicine (Licence: VA 0102206898) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2026-05-06 |