| NPI | 1073586632 |
|---|---|
| Former Name | REBECCA MOEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000301) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD 0301) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2022-03-30 |