| NPI | 1770842510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 330613) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 11758442-1205) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2024-08-15 |