| NPI | 1902057417 |
|---|---|
| Other Name | ELIZABETH LATRELLE TATUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME109486) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME1097486) |
| 208D00000X General Practice (Licence: FL ME109486) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2015-05-26 |