| NPI | 1962465138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OR MD28554) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WI 46312) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2012-12-12 |