| NPI | 1710307657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX U2295) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U2295) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NY 310652-01) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2023-03-29 |