| NPI | 1760085062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11009624) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL 11009624) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-18 |