| NPI | 1073855128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IA MD-47394) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WA 60363825) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2020-09-28 |