| NPI | 1104387075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2026-4560) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A200796) |
| 207W00000X Ophthalmology (Licence: NJ 25MA12048700) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-09-04 |