| NPI | 1578211140 |
|---|---|
| Former Name | CASSIDY PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 125.082539) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.082539) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2023-09-20 |