| NPI | 1487184859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2025017589) |
| Additional Taxonomies | 2086P0122X Surgery, Physician Nutrition Specialist (Licence: MO 2025017589) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2025-11-13 |