| NPI | 1104133933 |
|---|---|
| Former Name | CARRIE ANN MOAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19188) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305588) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2022-10-17 |