| NPI | 1821107772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 9700718) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101057810) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-05-25 |