| NPI | 1023464930 |
|---|---|
| Former Name | LESLIE DIANE MANESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036164036) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 63978) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-06-15 |