| NPI | 1285672519 |
|---|---|
| Former Name | CAROLYN J MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX L7818) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L7818) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-01-11 |