| NPI | 1669064945 |
|---|---|
| Former Name | AMANDA CATHERINE MOSES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2743) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA2743) |
| 363AM0700X Physician Assistant, Medical (Licence: KY TC016) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA2743) | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2023-06-29 |