| NPI | 1609212448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD60727229) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2018-00535) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 53469) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2022-12-13 |