| NPI | 1518173079 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101241432) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 240173) | 
| Enumeration Date | 2007-05-14 | 
| Last Update Date | 2015-03-23 |