| NPI | 1649717398 |
|---|---|
| Former Name | AMY PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.020463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026548) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2024-03-01 |