| NPI | 1912296427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA10061900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10061900) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2026-02-16 |