| NPI | 1396976205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 264867) |
| Additional Taxonomies | 208800000X Urology (Licence: FL TRN#14360) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 4307) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2015-11-02 |