| NPI | 1083659262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WA MD00037309) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD00037309) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2008-02-13 |