| NPI | 1972920296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35133143) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 51196) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2021-06-28 |