| NPI | 1336388792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: OK 1803) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OK PA1803) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2018-06-21 |