NPI | 1265817902 |
---|---|
Former Name | AMIE MIRANDA GAITHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-250-TA-A63) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2860) |
Enumeration Date | 2015-07-23 |
Last Update Date | 2025-01-06 |