| NPI | 1134270077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0026698) | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD D0026698) | 
| Enumeration Date | 2007-01-16 | 
| Last Update Date | 2010-06-20 |