| NPI | 1346313467 |
|---|---|
| Former Name | SUSAN ELIZABETH MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 332800) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 332800) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-07-07 |