| NPI | 1669620068 |
|---|---|
| Former Name | KATINA NICOLE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0072267) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2011-09-02 |