NPI | 1609096478 |
---|---|
Former Name | MELISSA M MANNING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA 39755) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101247778) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2021-11-29 |