| NPI | 1528287836 |
|---|---|
| Former Name | GWEN C ROESEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: SC MD40151) |
| Additional Taxonomies | 208800000X Urology (Licence: MI 4301109296) |
| 208800000X Urology (Licence: OH 35.090806) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2023-01-26 |