| NPI | 1790417541 |
|---|---|
| Doing Business As | MAGNIFICENT ADVANCED AESTHETICS PLLC |
| Entity Type | Organization |
| Authorized Contact | MIREYA LISS CEO 972-741-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-11-16 |