NPI | 1376022616 |
---|---|
Former Name | AMANDA BROOKE MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS 900593) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MS R900593) |
Enumeration Date | 2018-08-08 |
Last Update Date | 2022-12-20 |