| NPI | 1013202928 |
|---|---|
| Former Name | MARION ELIZABETH MOORMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101255982) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC MMD.33612 LL) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2023-08-11 |