NPI | 1730647389 |
---|---|
Former Name | CASEY MARIE BURKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2432) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07120) |
Enumeration Date | 2019-03-03 |
Last Update Date | 2024-11-05 |