| NPI | 1972590305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD-042431-E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD DOO36277) |
| 207W00000X Ophthalmology (Licence: FL ME64932) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-07-08 |