| NPI | 1013201722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 62245) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S34510) |
| 208200000X Plastic Surgery (Licence: AZ 62245) | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2023-01-26 |