| NPI | 1417118845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 255682-1) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 255682-1) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2011-07-13 |