NPI | 1053799098 |
---|---|
Former Name | MICHELLE ANDREA ESTRADA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 97836) |
Additional Taxonomies | 208600000X Surgery (Licence: TX BP10052708) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2024-03-03 |