NPI | 1073270237 |
---|---|
Former Name | BROOKE MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11018344) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9503424) |
Enumeration Date | 2021-11-23 |
Last Update Date | 2022-03-27 |