| NPI | 1639739717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KY 59796) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MO 2019018222) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2025-06-26 |