| NPI | 1215084439 |
|---|---|
| Former Name | ANNE ELIZABETH BERENBOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-34367) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 240818) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-06-22 |