| NPI | 1972033975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: CA 20A19700) |
| Additional Taxonomies | 208800000X Urology (Licence: PA OT018024) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-08-05 |