| NPI | 1104900778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MA 07468300) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 213110) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-05-17 |