| NPI | 1972741122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D85168) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: LA MD.207140) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2020-08-06 |