| NPI | 1396293908 |
|---|---|
| Former Name | TARA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: KS 116082) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |