| NPI | 1861695843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME129704) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA mt189161) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2018-08-10 |