| NPI | 1174100630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MT226345) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125077444) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2022-06-10 |