| NPI | 1811938905 |
|---|---|
| Former Name | GINA MICHELLE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 41375) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 41375) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-01-27 |