| NPI | 1174087977 |
|---|---|
| Former Name | CASEY KATHLEEN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007530) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA56478) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2025-02-19 |