| NPI | 1356979769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208800000X Urology (Licence: MN 79472) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-07-24 |