| NPI | 1548896657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7265065-4405) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH CNP0027075) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2021-11-12 |