| NPI | 1720437841 |
|---|---|
| Former Name | KATIE DIANE MOAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AR E-12249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-12249) |
| 207R00000X Internal Medicine (Licence: GA 008272) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-07-24 |