| NPI | 1730445644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A144488) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM RS2014-0672) |
| 207W00000X Ophthalmology (Licence: MA 262309) | |
| 207W00000X Ophthalmology (Licence: PA 0) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2018-07-23 |