| NPI | 1831299437 |
|---|---|
| Former Name | BETSY FUNK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4009) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT13590 TPA) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2009-10-12 |