| NPI | 1871937979 |
|---|---|
| Former Name | LAURA BETH BERGANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: KY 55621) |
| Additional Taxonomies | 208800000X Urology (Licence: CA A160427) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2021-08-03 |