| NPI | 1124580238 |
|---|---|
| Former Name | DENITA ROCHELLE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036174277) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2025-06-30 |