NPI | 1154811958 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 100641) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 238506) |
Enumeration Date | 2018-05-16 |
Last Update Date | 2024-07-08 |