| NPI | 1538505250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2020023232) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 81584) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD S630139014790) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2020-07-24 |