| NPI | 1063755791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61038945) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D84726) |
| 207W00000X Ophthalmology (Licence: PA MD463596) | |
| 207W00000X Ophthalmology (Licence: TX R3547) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-09-29 |