| NPI | 1902808538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D61303) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D61303) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2018-10-04 |