| NPI | 1962847673 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208800000X Urology (Licence: OR DO192530) | 
| Additional Taxonomies | 208800000X Urology (Licence: NC 2018-00838) | 
| Enumeration Date | 2013-05-08 | 
| Last Update Date | 2019-07-04 |