| NPI | 1568698769 |
|---|---|
| Former Name | KASEY JEAN MATTHES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 4217) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R-8682) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2013-06-13 |