| NPI | 1861952335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 335152) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101280479) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-06-17 |