NPI | 1295933638 |
---|---|
Former Name | CYNTHIA LORRAINE MOORHEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX J6606) |
Enumeration Date | 2007-07-06 |
Last Update Date | 2007-07-08 |