NPI | 1538587092 |
---|---|
Former Name | SHANNON ELEANOR MOSELEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR0058567) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-02 |
Last Update Date | 2022-07-21 |