| NPI | 1164596243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 204963-1) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME-71586) |
| 207W00000X Ophthalmology (Licence: CA G87745) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |