| NPI | 1104112879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 262235) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248156) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2019-04-29 |