| NPI | 1457619264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA A143072) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA ML60293421) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2021-03-31 |