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 |