| NPI | 1932971801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAVIS Credentialing Specialists 912-373-4385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist Nutrition, Education |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-10-24 |