| NPI | 1972865541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: NJ 25MB10130800) |
| Additional Taxonomies | 208800000X Urology (Licence: PA OT014534) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2024-04-26 |