| NPI | 1912348624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME141408) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX R2306) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2020-06-01 |