| NPI | 1114241429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD 00022386) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME 92698) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2017-03-10 |