NPI | 1073994455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A165032) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT209629) |
Enumeration Date | 2015-06-11 |
Last Update Date | 2021-07-16 |