| NPI | 1679694400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME116674) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 4301081903) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2016-02-16 |