| NPI | 1053802454 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 80895)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX T6053)  | 
| 207W00000X Ophthalmology (Licence: FL ME163116)  | |
| 207R00000X Internal Medicine (Licence: MA 275696)  | |
| 207W00000X Ophthalmology (Licence: NY 960492)  | |
| Enumeration Date | 2018-05-22 | 
| Last Update Date | 2025-07-23 |