| NPI | 1043628746 |
|---|---|
| Former Name | KASEY RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 5757) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A00635) | |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2025-03-11 |