| NPI | 1699967182 |
|---|---|
| Former Name | SHALONIE ROCHELLE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: SC 11661) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18433) |
| 183500000X Pharmacist (Licence: SC 11661) | |
| 183500000X Pharmacist (Licence: VA 0202207612) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2016-07-01 |