| NPI | 1013334150 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 63372)  | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL 036.143448)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 | 
| Last Update Date | 2022-03-26 |