| NPI | 1710447024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 80979) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 323297) |
| 207W00000X Ophthalmology (Licence: ME MD28296) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-08-18 |