| NPI | 1275336893 | 
|---|---|
| Professional Name | JUSTIN THOMAS MOORE | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61668130) | 
| Enumeration Date | 2025-03-29 | 
| Last Update Date | 2025-03-29 |