| NPI | 1023451317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 74191) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OR pg189173) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WA MD60951421) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2023-06-27 |