| NPI | 1558425678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 220384) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 046797) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2009-10-20 |