| NPI | 1629369350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2016-01613) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME123084) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 17107) | |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2019-10-18 |