| NPI | 1558410100 |
|---|---|
| Former Name | ERICA L. PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 10004) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 10004) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-12-18 |