| NPI | 1144669904 |
|---|---|
| Former Name | SARA ALICE FAULKENBERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1754) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2329) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2021-11-08 |