| NPI | 1225094659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301505730) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA06639100) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 2009-01735) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 2170261) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-02-02 |