NPI | 1376962316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WA 60660093) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: WA 60660093) |
2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WV 29791) | |
Enumeration Date | 2014-04-07 |
Last Update Date | 2024-08-22 |