| 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 |