| NPI | 1568408607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CT 041129) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 041129) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2015-05-05 |