| NPI | 1275979734 |
|---|---|
| Former Name | SHAE A. WIDICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL MD.41860) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 078308) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2022-01-11 |