| NPI | 1982109807 |
|---|---|
| Former Name | MADELEINE M BLANK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 65803) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 29119) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2020-08-27 |