| NPI | 1215590831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CT 80521) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 012361) | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2026-06-21 |