| NPI | 1578547386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 45957) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 57719) |
| 207W00000X Ophthalmology (Licence: WI 26116) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2021-07-06 |