| NPI | 1609800085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MA 1988) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1988) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2021-10-14 |