| NPI | 1669777512 |
|---|---|
| Former Name | TRACI LYNN MOSHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A9911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS1369) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2022-06-21 |