| NPI | 1972765121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 68308) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME 128555) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2020-09-14 |