| NPI | 1790951135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 051016) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 142368) |
| 207W00000X Ophthalmology (Licence: FL ME109589) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2013-11-11 |