NPI | 1952703795 |
---|---|
Former Name | DEBORAH M MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011606) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041247173) |
163W00000X Registered Nurse (Licence: IN 28125940A) | |
Enumeration Date | 2014-09-24 |
Last Update Date | 2014-10-06 |