Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 49296 | WI |
NPI | 1184646556 |
---|---|
Provider Name | Antoinette M Peters |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 04/06/2018 |