| NPI | 1104896513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 8213T) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: CA 8213T) |
| 152WP0200X Optometrist Pediatrics (Licence: CA 8213T) | |
| 152WS0006X Optometrist Sports Vision (Licence: CA 8213T) | |
| 152WX0102X Optometrist Occupational Vision (Licence: CA 8213T) | |
| 156FC0800X Technician/Technologist Contact Lens (Licence: CA 8213T) | |
| 156FC0801X Technician/Technologist Contact Lens Fitter (Licence: CA 8213T) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2010-11-29 |