| NPI | 1609137363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 60673) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 108917) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2022-07-21 |