NPI | 1801043021 |
---|---|
Former Name | SUSAN GAYLE BARNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4295) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007527) |
Enumeration Date | 2008-08-19 |
Last Update Date | 2016-07-20 |