| NPI | 1043292030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G62036) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI G620360) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-01-10 |