| NPI | 1417369034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: HI MD18591) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2024-03441) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 2024-03441) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2026-04-15 |