| NPI | 1629419023 |
|---|---|
| Former Name | CASEY ELIZABETH LIEB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4854) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 23096) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 4854-23) | |
| Enumeration Date | 2013-07-13 |
| Last Update Date | 2022-02-09 |