| NPI | 1619185592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD60087986) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 231512) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-04-13 |