| NPI | 1407266455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OR 198745) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OR 198745) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2021-05-10 |