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