| NPI | 1225392186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2021028031) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125059670) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WI 72474) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2021-09-07 |