| NPI | 1598383077 |
|---|---|
| Former Name | AUTUMN JOY LANTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: NC 5013306) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2021-06-23 |