NPI | 1841340726 |
---|---|
Former Name | RACHEL MARIE PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11068) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4328-23) |
363A00000X Physician Assistant (Licence: MN 1678) | |
363A00000X Physician Assistant (Licence: WA PA10005119) | |
Enumeration Date | 2007-01-11 |
Last Update Date | 2022-06-27 |