| NPI | 1285067918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 071561) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 271203) |
| 207W00000X Ophthalmology (Licence: CT 052609) | |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2014-04-15 |