| NPI | 1396004677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA10615300) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 292669) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2021-07-23 |