| NPI | 1558781179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME151972) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA 175636) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2026-06-04 |