| NPI | 1215279856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SD 10807) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 63978) |
| 207W00000X Ophthalmology (Licence: MI 4301103406) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2023-01-03 |