NPI | 1649798588 |
---|---|
Former Name | KELA NEQUE MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: NY J4G5A8R7) |
Additional Taxonomies | 247200000X Technician, Other (Licence: NY C8P3N8Q3) |
Enumeration Date | 2017-08-30 |
Last Update Date | 2019-05-23 |