| NPI | 1508279910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2024011403) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MD480968) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 162004) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301104772) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2024-10-04 |