| NPI | 1902968258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD00037271) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AK 4971) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2021-11-10 |