| NPI | 1063037133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.150439) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 58884) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-14 |
| Last Update Date | 2024-06-25 |