NPI | 1033572110 |
---|---|
Former Name | DEBORAH MOON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 290536) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-05 |
Last Update Date | 2019-06-13 |