| NPI | 1487855235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101266693) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9600529) |
| 208200000X Plastic Surgery (Licence: NC 9600529) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-08-02 |