| NPI | 1902053382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 78721) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2012042792) |
| 207W00000X Ophthalmology (Licence: TX P3020) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2020-01-15 |