| NPI | 1609305648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 51145) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 67700) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2025-06-09 |