| NPI | 1891757837 |
|---|---|
| Former Name | AMANDA M BRULEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE I3-0001328) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4024) |
| 152W00000X Optometrist (Licence: PA OEG000273) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2014-04-08 |