NPI | 1417613845 |
---|---|
Former Name | LATASHA RENEE HART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01153300) |
Enumeration Date | 2021-11-10 |
Last Update Date | 2022-06-01 |