NPI | 1558540518 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014253) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD002434) |
133V00000X Dietitian, Registered (Licence: NC L002333) | |
163WD0400X Registered Nurse, Diabetes Educator (Licence: NC 292466) | |
Enumeration Date | 2007-10-26 |
Last Update Date | 2025-07-01 |