| NPI | 1225099708 |
|---|---|
| Former Name | BRENDA MARIE FAULHABER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV006987) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC3855) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2014-01-24 |