NPI | 1265019020 |
---|---|
Former Name | LESLIE LUTKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95031916) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95198633) |
Enumeration Date | 2021-03-26 |
Last Update Date | 2024-10-14 |