| NPI | 1366737157 |
|---|---|
| Former Name | LISA DIANE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 006369) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q0675) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2018-09-20 |