| NPI | 1164747499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: VA 0101264554) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A118591) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A118591) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2018-12-27 |