| NPI | 1972745602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KY 55035) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 55035) |
| 208600000X Surgery (Licence: PA MT215390) | |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2021-07-23 |