| NPI | 1225329790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: TN MD0000048677) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME127163) |
| 208D00000X General Practice (Licence: TN 48677) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2022-07-20 |