NPI | 1720361660 |
---|---|
Former Name | SHEILA RAE PETERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004443) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001002979) |
Enumeration Date | 2011-09-27 |
Last Update Date | 2014-08-07 |