| NPI | 1740719251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: WA 61276895) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 41041) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-03 |