NPI | 1861898355 |
---|---|
Former Name | DESIREE PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MS R872705) |
Enumeration Date | 2014-11-10 |
Last Update Date | 2015-06-01 |