| NPI | 1710050141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35036423) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301034155) |
| 207W00000X Ophthalmology (Licence: CA G29024) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-09 |