| NPI | 1780626754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD465048) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 223589) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-10-12 |