NPI | 1669466520 |
---|---|
Former Name | JANICE LYNNE MOSELEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101058027) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0007532) |
Enumeration Date | 2005-09-07 |
Last Update Date | 2018-06-20 |