Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | P2059 | NC |
NPI | 1457852170 |
---|---|
Provider Name | Sarah Peterson |
First Address | Durham, NC 27705-2671 |
Second Address | Durham, NC 27705-2671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2018 |
Last Update Date | 27/02/2018 |