| NPI | 1124055561 |
|---|---|
| Former Name | MARK AVERY MOORE-FULLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 1901-320) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301093004) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2022-06-21 |