| NPI | 1831457860 |
|---|---|
| Former Name | JENNA GRACE CUSIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WI 61535-20) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WI 61535-20) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2025-08-21 |