| NPI | 1003209883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA PA5253) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA5253) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2019-06-11 |