NPI | 1902293004 |
---|---|
Former Name | CASEY MOSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2016020646) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005404) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2019-08-13 |