| NPI | 1710189931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 006018) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.008986) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2023-07-26 |