| 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 (Licence: NY C8P3N8Q3) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2019-05-23 |