| NPI | 1902199508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME126470) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 37900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2016-12-08 |