| NPI | 1972941748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 292898) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125062666) |
| 207W00000X Ophthalmology (Licence: WI 67480-20) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2019-10-03 |