NPI | 1013085679 |
---|---|
Former Name | MARQUISHA DENISE MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 28059) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL 28059) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2022-08-07 |