NPI | 1104387075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A200796) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA12048700) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2025-07-01 |