| NPI | 1528068061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 47858) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 050518) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2011-11-28 |