| NPI | 1194084327 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R6972) | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX BP10044390) | 
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX BP10044390) | |
| Enumeration Date | 2012-05-08 | 
| Last Update Date | 2018-09-05 |