| NPI | 1396382107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 293605) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2026-0003) |
| Enumeration Date | 2019-12-01 |
| Last Update Date | 2026-01-26 |