| NPI | 1376962316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WV 29791) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WA 60660093) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2021-11-18 |