| NPI | 1477126217 |
|---|---|
| Former Name | SAVANNA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 265926) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MO 2018001583) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-07-01 |