| NPI | 1215202551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 305870) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 128006) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2018-03-17 |