| NPI | 1417478264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: KS 15-01384) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 15-01384) |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2017-07-02 |