| NPI | 1205261161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY BM8695578) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME159833) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2023-11-17 |