| NPI | 1164700084 |
|---|---|
| Former Name | MELISSA VIRGINIA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 21217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 671197) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2016-03-02 |