| NPI | 1912324708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0102206347) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 34013417) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2021-06-07 |