| NPI | 1508297326 |
|---|---|
| Former Name | AMBER LATTERNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024992) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056159) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2022-12-06 |