| NPI | 1447954110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QP0002X Family Medicine, Physician Nutrition Specialist (Licence: NM DO2026-0113) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2023-1038) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2026-08-06 |