| NPI | 1154992550 |
|---|---|
| Former Name | MALLORY CAITLIN MAYERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN216727) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F06211739) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2022-09-08 |