| NPI | 1083459242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM 76714) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NM 2023033735) |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2025-04-04 |