| NPI | 1124140397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX P4355) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MD443178) |
| 208200000X Plastic Surgery (Licence: TX P4355) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-10-08 |