| NPI | 1851694194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX q6422) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT012444) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2022-07-21 |