| NPI | 1154765485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME135330) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 40815) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10046737) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2018-10-12 |