| NPI | 1104038231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 243820) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA08313100) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-03-07 |