| 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 | 2024-08-27 |