| NPI | 1639893399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: FL PA9116485) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116485) |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2022-12-07 |