| NPI | 1972853695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2016-00949) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT202080) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2016-08-15 |