| NPI | 1700226057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 73305) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301103422) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2021-12-03 |