| NPI | 1770719643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME141065) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101248177) |
| 207W00000X Ophthalmology (Licence: VA 0101248177) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2021-11-03 |