NPI | 1235124215 |
---|---|
Former Name | TERESA LYNN LUTKA-FEDOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD422963) |
Enumeration Date | 2005-09-15 |
Last Update Date | 2018-08-29 |