| NPI | 1639279516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD00046416) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301089763) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-11-28 |