| NPI | 1356464770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301084126) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NH 14739) |
| 208600000X Surgery (Licence: MN 52301) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2022-02-09 |