| NPI | 1972066678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: UT 13917929-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101271559) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-05-09 |