| NPI | 1356790851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 5101025758) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101022569) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2022-06-25 |