| NPI | 1609071364 |
|---|---|
| Former Name | JILL L. PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA 39362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R8125) |
| 207N00000X Dermatology (Licence: IA R8125) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2017-01-12 |