| NPI | 1679102669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX W1076) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME166255) |
| 207R00000X Internal Medicine (Licence: MA 284761) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-06-08 |