| NPI | 1841427085 |
|---|---|
| Former Name | AMANDA LAUREN MOSCHGAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053845) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004420) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-11-28 |