NPI | 1538789193 |
---|---|
Former Name | AMBER PETERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2021023273) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MO 2011025064) |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: KS 13-115858-122) | |
Enumeration Date | 2020-04-23 |
Last Update Date | 2021-09-14 |