| NPI | 1417363953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 51258) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35134038) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2018-06-11 |