| NPI | 1528217429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD60487152) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH application pending) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2016-07-06 |