| NPI | 1639790025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301514210) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME166906) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2025-07-14 |