| NPI | 1114379864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA10427800) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX 646185) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2018-12-14 |