| NPI | 1568063196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AL 1754) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 12719) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2024-11-23 |