| NPI | 1629691183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 4351054232) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL84359) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2025-05-28 |