NPI | 1578979209 |
---|---|
Former Name | REBECCA JEAN SHAPIRO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1969) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002338) |
Enumeration Date | 2014-07-02 |
Last Update Date | 2017-02-20 |