| NPI | 1194920595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 137240) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301097505) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2015-09-03 |