| NPI | 1467892729 |
|---|---|
| Former Name | JESSICA MARIE VAVRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN 65046) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: KY 50921) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KY 50921) | |
| 208600000X Surgery (Licence: MI L2492966) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2022-08-18 |