| NPI | 1164783544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MT 104726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R73383) |
| 207W00000X Ophthalmology (Licence: WA MD60894494) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2022-04-19 |