| NPI | 1942727680 |
|---|---|
| Former Name | HOLLISE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 583552) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 287851) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |