| NPI | 1508165382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.137440) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 60161) |
| 208600000X Surgery (Licence: CA A-121726) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX R9922) | |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2021-08-13 |