| NPI | 1790064285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CO DR.0064754) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.057674) |
| 208600000X Surgery (Licence: CO DR.0064754) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2020-10-07 |