| NPI | 1750871869 |
|---|---|
| Former Name | NICOLE CARENA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A175487) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2022-10-06 |