NPI | 1316277338 |
---|---|
Former Name | AISHA JENELLE MCKNIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 68934) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 68934) |
Enumeration Date | 2010-01-14 |
Last Update Date | 2024-12-05 |