| NPI | 1336521012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME169377) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT209249) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-05-07 |