NPI | 1902847056 |
---|---|
Other Name | EVELYN SANDRA MOODY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9179625) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP1243) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2011-02-23 |