| NPI | 1649366931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CT 037667) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 202853-1) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-07-09 |