| NPI | 1073546438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA10885200) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: MD DH64674) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-12-17 |