| NPI | 1962024497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IA R-12404) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-12286) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2022-06-23 |