| NPI | 1427429620 | 
|---|---|
| Former Name | HANNAH MOORE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KY PA2044)  | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY TC438)  | 
| Enumeration Date | 2015-10-13 | 
| Last Update Date | 2022-02-09 |