| NPI | 1912404567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CO DR.0071860) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101267939) |
| 208D00000X General Practice (Licence: VA 0101267939) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-01-02 |