| NPI | 1104386564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME161602) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX U5405) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-05-07 |