| NPI | 1740963040 |
|---|---|
| Former Name | DOREEN L PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95025947) |
| Additional Taxonomies | 363LX0106X Nurse Practitioner, Occupational Health (Licence: CA 95025947) |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |