| NPI | 1790314664 |
|---|---|
| Former Name | MARY KATHREN MOONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U1122) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2023-04-07 |