| NPI | 1760823512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME122017) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN 19123) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2022-06-01 |