| NPI | 1205995446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 0010-00601) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 005827) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2022-03-14 |