| NPI | 1962030213 |
|---|---|
| Former Name | KELLY ANN PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0102207450) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-06-06 |