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Individual
MR. DALTON ENRICO LATHAM
Active
Individual
MR. DALTON ENRICO LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP- NURSE PRACTITION
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704211443
MI
363LF0000X
Family Nurse Practitioner
4704211443
MI
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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