| NPI | 1235591199 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 87773) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 85719) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-22 | 
| Last Update Date | 2025-09-12 |