| NPI | 1962859892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 74979) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 77173) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2025-09-16 |