| NPI | 1336639558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: MA 1014934) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 237042) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2023-07-10 |