| NPI | 1710990197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA WA MD00035889) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR OR MD21079) |
| 207W00000X Ophthalmology (Licence: CA G 48562) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |