| NPI | 1790041697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A120821) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 273643) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-09-19 |