| NPI | 1972037521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD220526) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD61560800) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2024-09-30 |