| NPI | 1508150723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.139617) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MT199465) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2020-06-16 |