NPI | 1821523325 |
---|---|
Former Name | KARYN MOSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: ME MD26137) |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10957204-1205) |
208000000X Pediatrics (Licence: OH UE780322) | |
Enumeration Date | 2017-04-22 |
Last Update Date | 2024-08-19 |