| NPI | 1013439439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: UT 10893159-1205) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 57029097) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2022-07-21 |