| NPI | 1659635043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX R5739) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX R5739) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2021-03-08 |