NPI | 1174637060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MN 44333) |
Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TX K2093) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2020-11-10 |