| NPI | 1083730394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60041919) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301078043) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301078043) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2021-05-05 |