| NPI | 1215071014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CO 45303) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 45303) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2008-03-03 |