| NPI | 1861654717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD60579867) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MO 2008016447) |
| 208200000X Plastic Surgery (Licence: CA A130253) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2017-02-08 |