| NPI | 1992798706 |
|---|---|
| Former Name | DEBORA MOELLENBERNDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA53892) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.966) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 101190) | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2023-03-23 |