| NPI | 1134121015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2018-02527) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 39949) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2023-02-23 |