| NPI | 1255629911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 71684) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 274465) |
| 208200000X Plastic Surgery (Licence: GA 074258) | |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2022-10-27 |