| NPI | 1972249894 |
|---|---|
| Former Name | SAMANTHA K PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301518692) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-17425) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2026-09-02 |