| NPI | 1205463718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 345779) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NY 345779) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2023-07-03 |