NPI | 1003997925 |
---|---|
Former Name | LISA M CASEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2005022710) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2005022710) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2024-10-03 |