| NPI | 1891101531 |
|---|---|
| Former Name | LATEEF JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61066827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 37285) |
| 207Q00000X Family Medicine (Licence: SC LL37285) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-04-13 |