| NPI | 1063606374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61054774) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A104458) |
| 207W00000X Ophthalmology (Licence: AK 159123) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2020-12-09 |