| NPI | 1821183856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA MD60396514) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 75430) |
| 208800000X Urology (Licence: WI 3552) | |
| 208800000X Urology (Licence: TX 41429) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-01-04 |