| NPI | 1750467189 |
|---|---|
| Former Name | STEPHANIE COOPER VASTOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 176149-01) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 176149) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-02-21 |