| NPI | 1902961667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 198392) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G85618) |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2007-07-08 |