| NPI | 1407922685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME122654) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX N4589) |
| 208600000X Surgery (Licence: LA 025562) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2025-07-31 |