| NPI | 1568661288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA 136371) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME EC071020) |
| 208600000X Surgery (Licence: WI 52158-020) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2015-07-08 |