| NPI | 1730391228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2017-00894) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101017045) |
| 225100000X Physical Therapist (Licence: MI 5501013003) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2019-04-14 |