| NPI | 1104023712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: HI 15307) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI 15307) |
| 208D00000X General Practice (Licence: HI 15307) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2022-06-29 |