| 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 |