| NPI | 1952628158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301105322) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 105651) |
| 207W00000X Ophthalmology (Licence: MN 54336) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2014-05-14 |