| NPI | 1912167719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A107997) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD151034) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2011-08-08 |