| NPI | 1790218113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 73742) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 30344) |
| 207W00000X Ophthalmology (Licence: MN 29003) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2020-10-02 |