| NPI | 1033662242 |
|---|---|
| Professional Name | LATISHA BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NE 112100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 56246) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-09-06 |