| NPI | 1871041707 |
|---|---|
| Former Name | MEGAN CLAIRE MANNEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 4645ATI) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 152W00000X Optometrist (Licence: UT 10778678-9934) | |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2022-08-02 |