| NPI | 1598512964 |
|---|---|
| Former Name | AMY PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NY 728876) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |