| NPI | 1881784106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD033138E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WV 17583) |
| 207W00000X Ophthalmology (Licence: OH 35066784) | |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2007-10-18 |