| NPI | 1790310894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX V4769) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.154577) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2025-12-23 |