| NPI | 1053576991 |
|---|---|
| Former Name | YVETTE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 1328) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 1328) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-02-09 |