| NPI | 1689660425 |
|---|---|
| Former Name | TINA M LATTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71003623A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704205664) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2023-03-13 |