| NPI | 1811156144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD60300264) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD15472) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2012-12-19 |