| NPI | 1851640767 |
|---|---|
| Former Name | CHARLENE LAURA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 100933) |
| Additional Taxonomies | 364SC1501X Clinical Nurse Specialist Community Health/Public Health (Licence: MT NUR-RN-LIC-47637) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2019-03-08 |