| NPI | 1487711586 |
|---|---|
| Former Name | LYNN ELLEN RETTIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ AP5555) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001704) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2019-02-01 |