| NPI | 1710259981 |
|---|---|
| Former Name | MELANIE V MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS17408) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 1147) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2021-05-18 |