| NPI | 1912544545 |
|---|---|
| Former Name | AMY ELIZABETH LATHEM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.024034) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH cnp.024034) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2023-10-09 |