| NPI | 1003291998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX BP10054161)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10054161)  | 
| Enumeration Date | 2015-07-21 | 
| Last Update Date | 2015-07-24 |